Antibiotics could cure chronic back pain, study finds

Antibiotics could cure 40% of chronic back pain patients. Up to four in 10 cases of chronic lower back pain could be cured by antibiotics, research has suggested. Around five million people in Britain will suffer chronic back pain at some point in their lives, and the cause is often not clear.

Antibiotics could cure 40pc of chronic back pain patients

Up to four in 10 cases of chronic lower back pain could be cured by antibiotics, research has suggested.

Around five million people in Britain will suffer chronic back pain at some point in their lives, and the cause is often not clear.

The research by the University of Southern Denmark found that almost half of cases of chronic lower back pain could in fact be caused by bacteria.

Of those, most were cured or significantly improved by one three-month dose of antibiotics – at a cost of just £114 per patient – the study found.

Currently, the NHS spends more than £1 billion a year on treatment of back pain, while patients spend at least £600 million a year on private healthcare and alternative remedies.
The Danish studies, published in the European Spinal Journal, found the presence of bacteria in 46 per cent of patients suffering from chronic lower back pain following a slipped or herniated disc.

Researchers suggested that the problems occur because when a disc becomes herniated, bacteria can enter and cause an infection – causing bone swelling and persistent pain.

Their second study of 162 patients found that when such cases were given the antibiotic combination amoxicillan and clavulanate, 80 per cent were cured or saw a significant reduction in their pain levels.

Peter Hamlyn, a consultant neurologist and spinal surgeon at University College London hospital said the discoveries were so significant that in future, half of all patients who would otherwise endure spinal surgery might instead be helped by antibiotics.

While more research was required to confirm the findings, he said the discovery appeared to be a major breakthrough in tackling one of the most common causes of disability.

He said: “Make no mistake this is a turning point, a point where we will have to re-write the textbooks,” he said. “It is the stuff of Nobel prizes.”

It has long been known that it is possible for infections to cause back pain, but these cases had been thought to be rare.

Dr Hanne Albert, of the Danish research team, said the findings could give patients who suffer constant pain “a form of normality they would never have expected.”
Experts likened the findings to a breakthrough thirty years ago, when the bacteria Helicopter pylori was found to be the cause of gastritis and stomach ulcers, radically changing the way they were treated.

John O’Dowd, President of the British Society for Back Pain Research, said: “It is a very striking study, and those behind it are a very high calibre group of scientists. This is definitely something we need to take seriously but the results are very surprising and this is an area where there is a great deal of uncertainty.”

He said more studies needed to be carried out to replicate the findings before the NHS changed its advice.

“I wouldn’t want to see a great rush to market this as the best response to chronic lower back pain until that has been done,” he said.

Prof Laura Piddock, Professor of Microbiology from the University of Birmingham said antibiotics should only be used to treat back pain once a bacterial cause had been identified.

Otherwise far too many people could be “needlessly” exposed to the drugs, she said, increasing their likelihood of becoming resistant to them, and at risk of future infections.
Prof Piddock, deputy director of The Institute of Microbiology and Infection, said doctors needed to liaise with microbiologists to ensure specific tests were carried out before antibiotics were prescribed for back pain.

A spokesman for the National Institute for Health and Care Excellence, which recommends which treatments are funded by the NHS, said the research would be considered next time its guidelines on back pain are reviewed

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